Qualitative differences between traditional and rural-longitudinal medical student OSCE performance

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Physician Associate Programs

Background:

• Long-term preceptorships are being reintroduced in medical training for enhanced observation, supervision, and mentoring.
• Previous studies indicated academic equivalence between longitudinal (Rural Physician Associate Program - RPAP) and traditional medical students.
• Objective Structured Clinical Examinations (OSCE) are used to evaluate clinical performance.

Purpose of the Study:

• To qualitatively assess and compare the OSCE performances of longitudinal and traditional medical students.
• To identify differences in clinical skills and patient interaction patterns between the two educational models.

Main Methods:

• A qualitative review of end-of-session OSCE videotapes was conducted for high and low performing longitudinal (n=47) and traditional (n=60) students.
• Four specific OSCE scenarios were analyzed: cough, adolescent dysuria, preventive care for older males (PSA test), and medication reconciliation.
• Three researchers independently reviewed 16 selected videotapes, discussing emergent themes and subthemes over four meetings.

Main Results:

• Longitudinal students demonstrated more consistent rapport-building skills and effective patient interaction patterns.
• Longitudinal students were more adept at explaining preventive care recommendations, such as the prostate-specific antigen (PSA) test.
• Traditional students showed greater mastery of adolescent interviews and adherence to lecture-based mnemonics.

Conclusions:

• Qualitative OSCE analysis reveals insights beyond quantitative scores, highlighting differences in clinical practice.
• Longitudinal students exhibited superior rapport-building, content knowledge, and a more effective patient encounter routine.
• The findings suggest that long-term rural training may foster distinct and advantageous clinical interaction skills.